Complete resection of an infrequent tumor in the lower third of esophagus by laparoscopy via abdominal

2013 
A gastrointestinal stromal tumor (GIST) is an infrequent tumor with a complex development of disease. This kind of tumor shares a unique characteristic: a KIT-activated mutation, which differentiates them from other mesenchymal malignancies. In half of cases, localization is in stomach, less frequent locations are: omentum, peritoneum, rectum and esophagus. Treatment mainly consist is surgical resection and target therapy. This article’s main objective is to report a totally laparoscopic abdominal resection of a GIST tumor located in lower third of esophagus that was found during a laparoscopic procedure carried on for a different cause than found it. Medical record is: a 48 -years-old- male with previous story of gastro-esophageal refl ux disease that underwent to elective laparoscopic fundoplication, during hiatus dissection, the presence of a 5 cm bilobulated-tumor in lower third of esophagus was observed. Excisional biopsy was taken and reported the probability of GIST. We could identify tumor was attached to esophagus’s superfi cial planes so a complete dissection without breaking tumor’s pseudo-capsule was achieved. Defi nitive histopathology report was: surgical specimen with free margins of disease and immunohistochemical staining confi rmed the GIST diagnosis. Incidence of GIST in lower third of esophagus is a rare and infrequent condition; hence, there are not many reports of totally laparoscopic abdominal resection in tumors bigger than 2 cm; So that’s the purpose of reporting this surgical achieve with satisfactory results. The fi rst of its kind reported in a medical center in the State of Mexico.
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